Never say never. My former employer's retirement plan is an advantage plan and is every bit as good as as any Part-C plan, and much cheaper. The thing that scared me about the supplements is the insurance pools drying up, driving premiums through the roof.
6:53 I had a Medigap plan to begin with which basically eliminated all the co-pays for not too much more than a Medicare Advantage plan. After 5 years, the cost increased from around $150 per month to more than $300 per month. At that point I could get the same coverage through an Advantage plan and what I would spend in co-pays wouldn’t come close to the Medigap premium. The premium is $66 per month. O’ e had a series of surgeries and other procedures all without much of a co-pay.
Agree. I had an Advantage Plan last year and they denied a heart cath that my cardiologist felt I needed. This occurred during the last enrollment period so I switched to original Medicare where there is no pre-authorization. Once the switch was made, I got my heart cath which showed I had two coronary arteries blocked 100% and a third blocked 80%. I was a "ticking time bomb." I could have applied for an appeal with the Advantage Plan, but I would have been risking a heart attack waiting for an approval (or disapproval). Remember, Advantage Plans have pre-authorizations and physician networks. I'll stick to original Medicare and if my costs go up, I'll consult with a pro like Emily to help me shop for another plan.
@@wtc8184 Like anything, one size doesn't fit all. Not all advantage plans are the same. In many ways, my retirement advantage plan is better than the medicare supplement I had before. I have no pre-authorization, or even referral, and can see anyone in the country who takes Medicare as payment. If I didn't have this particular plan, I would have stayed on Plan-G, though I think Plan-F is a better idea, long-term. There is a risk of premiums for any Medicare plan to go through the roof. What worries me about the traditional Medicare plans is the fixed insurance pool. The better plans tend to attract people who use more medical care. As people die off, there are fewer in the pool to pay into the pool, increasing premiums. The increasing cost chases the healthier people out to other, larger, pools with people who use fewer services. The people left behind are those who can't get underwritten for other plans, and the costs spiral out of control.
I just got my statement for 2025 from BCBS. My premium for Plan F High Dedectuble supplement plan went down $10/mo to just $54. I also get a few hundred back each year in a refund.
My husband is on VA Medicare (he is low level 8 - whatever that means. He was not wounded and he did not complete 20 years service).. would I qualify for VA Medicare coverage under his VA benefits?
VA benefits have their own set of rules! We would highly recommend contacting them and seeing exactly what you are covered by and they can provide a better in depth look at what you have available to you!
I find this to be ex tree extremely confusing. We're on Medicare A&B primary & also pay for FEP BC/BS self+1 premiums (for yrs since hubby retired). We use the BC/BS drug plan instead of their part D because we couldn't figure out if BC/BS is an advantage or supplement plan & it also seemed we were better off staying with BC/BS drug plan & getting our meds thru Costco instead of going with D. BTW hubby's a stage 4 cancer patient who's now dealing with ESRD. For 2024 BC/BS was going to move us to part D; we declined & stayed with what we knew. We're going to have to make the same decision for 2025 whether to remain with BC/BS drug plan or switch to the part D plan. Again it's going to be a nightmare scenario trying to figure out what's what & what's best. Like I said in the beginning, it's all very confusing & just about impossible to make sense of this without gazing into a murky crystal ball😮🤷♀️.
FEP plans are more complicated than others. The rules are different if you are actively working vs retired. And some work better with Medicare than others. For our clients with FEP, we want to know all the plans they can access then help them with the best coverage for the lowest cost.
Stay with your fep bc/bs plan. I am on the same plan for the last 17 yrs. I went through cancer and never had any bills to pay. I hope it hasn't changed for you,but never give up your fep status. God bless.
👋 Just liked and subscribed. Quick question, 70 yo, on UHC, supplemental + RX coverage, plan F. My doc ordered Rybelsus, needed prior authorization, was denied, apparently because I had no dx of diabetes or heart disease, just overweight…. Any suggestions how I can get this covered? lol I’m too healthy, preventative medicine does not get covered. Thanks! Looking forward to future videos. Victoria
Hi there! Great question, with Medicare they will only cover prescription medications if they are medically necessary, due to using Rybelsus but not having Diabetes or Heart Disease, Medicare may not cover that particular medication however you can bring that up to your Doctor and see if they can prescribe a different drug for that same reason.
So far, Part C plans have been working for me. But is it possible to get out of an Advantage Plan and rely on Part B alone during the enrollment period? I have no reason to do that now, because my Part C plan has zero premium, and it pays for my meds. But if I got off the meds, and wanted to see docs out of Part C networks in the future, can I drop Part C and rely on Part B alone?
You would have to wait til an enrollment period to get back into Part C/Advantage. If you wanted to see out of network doctors, you may want to consider looking into Medigap
@@Red-n5ryes probably unless you are on a advantage plan that is eliminated in that case you are guaranteed issue of the med supplement. There are going to be a lot of those this year!
When can we enroll in Payment Smoothing ? Thanks for your video. There’s so much to remember…Medicare makes it confusing for the elderly. It’s confusing for a 32 year old let alone other people. Medicare should not be allowed to make so many changes (in their favor).
Good question, at this point the enrollment details haven't been announced but we expect to be able to enroll in them on October 15 once AEP officially starts
Good question, if you are on Medicare before 65 because of SSDI, supplement plans can be more expensive if offered in your state. Plans tend to have lower premiums once you turn 65.
![Lp. Сердце Вселенной #60 РОЖДЕНИЕ ЛОЛОЛОШКИ [Финал] • Майнкрафт](http://i.ytimg.com/vi/YoR0pAV9FVQ/mqdefault.jpg)
They deducted 184 dollars off my check I’m on ssi
I would NEVER choose an Advantage plan!
Never say never. My former employer's retirement plan is an advantage plan and is every bit as good as as any Part-C plan, and much cheaper. The thing that scared me about the supplements is the insurance pools drying up, driving premiums through the roof.
6:53 I had a Medigap plan to begin with which basically eliminated all the co-pays for not too much more than a Medicare Advantage plan. After 5 years, the cost increased from around $150 per month to more than $300 per month. At that point I could get the same coverage through an Advantage plan and what I would spend in co-pays wouldn’t come close to the Medigap premium. The premium is $66 per month. O’ e had a series of surgeries and other procedures all without much of a co-pay.
I would and do.
Agree. I had an Advantage Plan last year and they denied a heart cath that my cardiologist felt I needed. This occurred during the last enrollment period so I switched to original Medicare where there is no pre-authorization. Once the switch was made, I got my heart cath which showed I had two coronary arteries blocked 100% and a third blocked 80%. I was a "ticking time bomb." I could have applied for an appeal with the Advantage Plan, but I would have been risking a heart attack waiting for an approval (or disapproval). Remember, Advantage Plans have pre-authorizations and physician networks. I'll stick to original Medicare and if my costs go up, I'll consult with a pro like Emily to help me shop for another plan.
@@wtc8184 Like anything, one size doesn't fit all. Not all advantage plans are the same. In many ways, my retirement advantage plan is better than the medicare supplement I had before. I have no pre-authorization, or even referral, and can see anyone in the country who takes Medicare as payment. If I didn't have this particular plan, I would have stayed on Plan-G, though I think Plan-F is a better idea, long-term.
There is a risk of premiums for any Medicare plan to go through the roof. What worries me about the traditional Medicare plans is the fixed insurance pool. The better plans tend to attract people who use more medical care. As people die off, there are fewer in the pool to pay into the pool, increasing premiums. The increasing cost chases the healthier people out to other, larger, pools with people who use fewer services. The people left behind are those who can't get underwritten for other plans, and the costs spiral out of control.
Good info! Thanks for sharing!
Glad it was helpful!
Just found your channel and am glad I did. Great info, I liked and subscribed………
Very clear and important information. Thank you
thank you for watching!
I just got my statement for 2025 from BCBS. My premium for Plan F High Dedectuble supplement plan went down $10/mo to just $54. I also get a few hundred back each year in a refund.
My husband is on VA Medicare (he is low level 8 - whatever that means. He was not wounded and he did not complete 20 years service).. would I qualify for VA Medicare coverage under his VA benefits?
VA benefits have their own set of rules! We would highly recommend contacting them and seeing exactly what you are covered by and they can provide a better in depth look at what you have available to you!
You are a really good presenter.
thank you for your kind feedback!
When will hearing aids be included.
Good question, at this point there isn't a timeline for hearing aids to be added to standard Medicare coverage
I find this to be ex tree extremely confusing. We're on Medicare A&B primary & also pay for FEP BC/BS self+1 premiums (for yrs since hubby retired). We use the BC/BS drug plan instead of their part D because we couldn't figure out if BC/BS is an advantage or supplement plan & it also seemed we were better off staying with BC/BS drug plan & getting our meds thru Costco instead of going with D. BTW hubby's a stage 4 cancer patient who's now dealing with ESRD. For 2024 BC/BS was going to move us to part D; we declined & stayed with what we knew. We're going to have to make the same decision for 2025 whether to remain with BC/BS drug plan or switch to the part D plan. Again it's going to be a nightmare scenario trying to figure out what's what & what's best. Like I said in the beginning, it's all very confusing & just about impossible to make sense of this without gazing into a murky crystal ball😮🤷♀️.
FEP plans are more complicated than others. The rules are different if you are actively working vs retired. And some work better with Medicare than others. For our clients with FEP, we want to know all the plans they can access then help them with the best coverage for the lowest cost.
Stay with your fep bc/bs plan. I am on the same plan for the last 17 yrs. I went through cancer and never had any bills to pay. I hope it hasn't changed for you,but never give up your fep status. God bless.
@@jjw9222you must have the unicorn level FEP then.
@tioswift3676 I have no idea what the unicom level is. I have the least costly self. It pays whatever Medicare doesn't
@@jjw9222 Unicorn = only dreamed about, never seen
Thanks. Good information.
thank you for watching!
Some Advantage Plans do not have deductible
That can be correct yes!
Does the 2000 cap include the plan $500-plus deductible
Yes, the amount you pay towards the $590 deductible counts towards the $2k cap.
That is correct yes!
I just turned 64 this month and am wondering about my options next year. Currently I am on no meds, and in good health.
No meds here. I went with the cheapest part D plan available. $4 / month. (NY)
you should join our free workshop! You can register for our next workshop by going here: join.themedicarecoach.com/free-workshop
Tempting, but don’t do it.
This was very helpful. Thank you!
Glad it was helpful!
Is there any way Medicare will cover supplements. They are not prescribed that are in place of former prescription drugs.
Medicare will not cover supplements that are not prescribed by a Doctor just due to them covering Medically necessary prescriptions.
Nutritional supplements have no proven value. Government shouldn’t pay for them.
👋
Just liked and subscribed. Quick question, 70 yo, on UHC, supplemental + RX coverage, plan F. My doc ordered Rybelsus, needed prior authorization, was denied, apparently because I had no dx of diabetes or heart disease, just overweight…. Any suggestions how I can get this covered? lol I’m too healthy, preventative medicine does not get covered.
Thanks! Looking forward to future videos.
Victoria
Please appeal this decision.
Hi there! Great question, with Medicare they will only cover prescription medications if they are medically necessary, due to using Rybelsus but not having Diabetes or Heart Disease, Medicare may not cover that particular medication however you can bring that up to your Doctor and see if they can prescribe a different drug for that same reason.
So far, Part C plans have been working for me. But is it possible to get out of an Advantage Plan and rely on Part B alone during the enrollment period? I have no reason to do that now, because my Part C plan has zero premium, and it pays for my meds. But if I got off the meds, and wanted to see docs out of Part C networks in the future, can I drop Part C and rely on Part B alone?
You would have to wait til an enrollment period to get back into Part C/Advantage. If you wanted to see out of network doctors, you may want to consider looking into Medigap
I'm pretty sure you will need to go through underwriting.
What ever!
yes please have a c plan or a supplement as without you have no protection on how much you could owe out of pocket.
@@Red-n5ryes probably unless you are on a advantage plan that is eliminated in that case you are guaranteed issue of the med supplement. There are going to be a lot of those this year!
When can we enroll in Payment Smoothing ? Thanks for your video. There’s so much to remember…Medicare makes it confusing for the elderly. It’s confusing for a 32 year old let alone other people. Medicare should not be allowed to make so many changes (in their favor).
Good question, at this point the enrollment details haven't been announced but we expect to be able to enroll in them on October 15 once AEP officially starts
Zero copay tier one generics will probably be no longer to help support the two thousand dollar cap.
We hope there will be some $0 copays, but we will know more October 1st.
I am on disability for Medicare. I wish the supplement plans weren’t so expensive. Any changes for us?
Good question, if you are on Medicare before 65 because of SSDI, supplement plans can be more expensive if offered in your state. Plans tend to have lower premiums once you turn 65.
Payment smoothie 😮no thanks just let me die 😅